6 ms·

Isn’t this the normal, expected, and preferred method for a drug to fail? The alternative failure mode is: drug gets to market, later on is found to have horrib

Isn’t this the normal, expected, and preferred method for a drug to fail? The alternative failure mode is: drug gets to market, later on is found to have horrible side effects and harms a lot of people. See e.g. Vioxx.

dvh 7y ago
I think the reverse is also more common. Drug get pass the "causes no harm" phase and they start putting it into everything. Recently I've seen glue used as both spermicide and in eye drops.
- dvh 7y ago
  I really don't understand why am I being downvoted. The drug in question is Carbomer 974P which is bioadhesive (a glue) and is used in spermicides and eydrops (e.g. Oftagel). Similar drug that is recently being put into everything is hyaluronic acid.
dcminter 7y ago
Oh, absolutely - but I think Derek's point in the article is that many critics of "Big Bad Pharma" who see the profitable drugs making it to market are unaware of the expensive failures that never make it that far.
- skohan 7y ago
  > many critics of "Big Bad Pharma" who see the profitable drugs making it to market are unaware of the expensive failures that never make it that far. But I think this image - that pharmaceutical companies are constantly risking their financial future pouring resources into research for new drugs which will finally cure some disease that has plagued humanity - is also a mischaracterization of reality. For instance, drug companies also spend a large portion of their research budget developing "novel compounds" which are based on small chemical changes to existing drugs, just for the purpose of extending their patent and increasing the profitability (read: cost to consumer) of an existing treatment. So it's not as if all the resources they put in to research represent some altruistic good. To be honest, I think the incentive structure for drug companies, like many things in healthcare, is just not ideal for producing the best outcomes. Their ideal business model is to own expensive drugs which sick people have to take for their entire lives. If they produce truly curative treatments, that's actually a net loss for them. As some people have suggested, it would make a lot of sense to nationalize drug research in the US. The idea is you bring the top pharmaceutical researchers into the NIH, and while this would require a big up-front investment, you might even be able to operate at a profit by licensing the drugs they develop to the rest of the world. Also, in a single-payer world, you would have the healthcare provider under the same financial umbrella as the people creating the drugs. As a result, the incentive would be to drive treatment costs down.
  - new299 7y ago
    > just for the purpose of extending their patent I don’t understand this point, though I’ve heard it before. If the original patents expire, the original drugs can be manufactured as generics right? If the new patents provide no new benefit, don’t use them? > The idea is you bring the top pharmaceutical researchers into the NIH... Projects I’ve seen suggests that technology development carried out in an academic context often requires significant refinement (or complete reworking tbh) when being brought to market. So, it’s not clear to me how well the model you suggest would work. Perhaps it would be best to have a public organization that manufactures genetic drugs first and build from that. But... I think that may also have issues.
    - skohan 7y ago
      > I don’t understand this point, though I’ve heard it before. If the original patents expire, the original drugs can be manufactured as generics right? If the new patents provide no new benefit, don’t use them? So it's because of a loophole created in the Hatch-Waxman act, which basically stipulates that if a drug company creates a "new chemical version" of a name-brand drug, then it's possible to extend the patent for 5 years and block the FDA approval of any generics. [0] [0]: https://www.upcounsel.com/how-long-does-a-drug-patent-last https://www.upcounsel.com/how-long-does-a-drug-patent-last > Projects I’ve seen suggests that technology development carried out in an academic context often requires significant refinement (or complete reworking tbh) when being brought to market. So, it’s not clear to me how well the model you suggest would work. So the problem, as I see it, is that the people who profit from the production and sale of drugs also have an essential monopoly over the talent pool which is capable of developing new drugs. As a result, the incentive is for them to direct their R&D resources in ways which maximize profitability rather than maximize health outcomes. In such a system as I have described, there would still be room for drug companies to do the work of producing drugs, but the incentives for the R&D process could be aligned with the general population rather than drug company shareholders. The current system represents something of a conflict of interest.
      - refurb 7y ago
C1sc0cat 7y ago
Or Thalidomide which luckily for the USA was stopped by the FDA.
- ncmncm 7y ago
  An example of sexism causing tragedy. It was only tested on male animals because they were easier, and it was allowed.

dvh 7y ago

I think the reverse is also more common. Drug get pass the "causes no harm" phase and they start putting it into everything. Recently I've seen glue used as both spermicide and in eye drops.

dvh 7y ago
I really don't understand why am I being downvoted. The drug in question is Carbomer 974P which is bioadhesive (a glue) and is used in spermicides and eydrops (e.g. Oftagel). Similar drug that is recently being put into everything is hyaluronic acid.

dcminter 7y ago

Oh, absolutely - but I think Derek's point in the article is that many critics of "Big Bad Pharma" who see the profitable drugs making it to market are unaware of the expensive failures that never make it that far.

skohan 7y ago
> many critics of "Big Bad Pharma" who see the profitable drugs making it to market are unaware of the expensive failures that never make it that far. But I think this image - that pharmaceutical companies are constantly risking their financial future pouring resources into research for new drugs which will finally cure some disease that has plagued humanity - is also a mischaracterization of reality. For instance, drug companies also spend a large portion of their research budget developing "novel compounds" which are based on small chemical changes to existing drugs, just for the purpose of extending their patent and increasing the profitability (read: cost to consumer) of an existing treatment. So it's not as if all the resources they put in to research represent some altruistic good. To be honest, I think the incentive structure for drug companies, like many things in healthcare, is just not ideal for producing the best outcomes. Their ideal business model is to own expensive drugs which sick people have to take for their entire lives. If they produce truly curative treatments, that's actually a net loss for them. As some people have suggested, it would make a lot of sense to nationalize drug research in the US. The idea is you bring the top pharmaceutical researchers into the NIH, and while this would require a big up-front investment, you might even be able to operate at a profit by licensing the drugs they develop to the rest of the world. Also, in a single-payer world, you would have the healthcare provider under the same financial umbrella as the people creating the drugs. As a result, the incentive would be to drive treatment costs down.
- new299 7y ago
  > just for the purpose of extending their patent I don’t understand this point, though I’ve heard it before. If the original patents expire, the original drugs can be manufactured as generics right? If the new patents provide no new benefit, don’t use them? > The idea is you bring the top pharmaceutical researchers into the NIH... Projects I’ve seen suggests that technology development carried out in an academic context often requires significant refinement (or complete reworking tbh) when being brought to market. So, it’s not clear to me how well the model you suggest would work. Perhaps it would be best to have a public organization that manufactures genetic drugs first and build from that. But... I think that may also have issues.
  - skohan 7y ago
    > I don’t understand this point, though I’ve heard it before. If the original patents expire, the original drugs can be manufactured as generics right? If the new patents provide no new benefit, don’t use them? So it's because of a loophole created in the Hatch-Waxman act, which basically stipulates that if a drug company creates a "new chemical version" of a name-brand drug, then it's possible to extend the patent for 5 years and block the FDA approval of any generics. [0] [0]: https://www.upcounsel.com/how-long-does-a-drug-patent-last https://www.upcounsel.com/how-long-does-a-drug-patent-last > Projects I’ve seen suggests that technology development carried out in an academic context often requires significant refinement (or complete reworking tbh) when being brought to market. So, it’s not clear to me how well the model you suggest would work. So the problem, as I see it, is that the people who profit from the production and sale of drugs also have an essential monopoly over the talent pool which is capable of developing new drugs. As a result, the incentive is for them to direct their R&D resources in ways which maximize profitability rather than maximize health outcomes. In such a system as I have described, there would still be room for drug companies to do the work of producing drugs, but the incentives for the R&D process could be aligned with the general population rather than drug company shareholders. The current system represents something of a conflict of interest.
    - refurb 7y ago

C1sc0cat 7y ago

Or Thalidomide which luckily for the USA was stopped by the FDA.

ncmncm 7y ago
An example of sexism causing tragedy. It was only tested on male animals because they were easier, and it was allowed.